Korean J Radiol.  2010 Aug;11(4):493-496. 10.3348/kjr.2010.11.4.493.

Confident Diagnosis of Bronchobiliary Fistula Using Contrast-Enhanced Magnetic Resonance Cholangiography

• Karabulut
• Cakmak V
• Kiter G

• KMID: 984907
• DOI: http://doi.org/10.3348/kjr.2010.11.4.493

Abstract

We report the utility of contrast-enhanced magnetic resonance cholangiography (MRC) using gadoxetic acid (Gd-EOB-DTPA) in the diagnosis of bronchobiliary fistula associated with liver hydatid cyst. Contrast-enhanced MRC clearly delineated the leakage of contrast agent from the biliary duct and its communication with the bronchial tree. Providing functional information about physiologic or pathologic biliary flow in addition to the display of biliary anatomy, contrast-enhanced MRC stands as a robust technique in confidently detecting bronchobiliary fistula and bile leaks.

Keyword

Bronchobiliary fistula; Gd-EOB-DTPA; Hepatobiliary contrast; Cholangiography; Biliary stent

MeSH Terms

Biliary Fistula/*diagnosis/pathology/surgery
Bronchial Fistula/*diagnosis/pathology/surgery
*Cholangiopancreatography, Magnetic Resonance
Contrast Media/diagnostic use
Decompression, Surgical
Female
Gadolinium DTPA/diagnostic use
Humans
Middle Aged
Stents
Tomography, X-Ray Computed

Figure

• 

  Fig. 1 Bronchobiliary fistula in 56-year-old woman. A. Chest CT shows distal subsegmental atelectasis and air bronchograms in right middle lobe. B. Targeted coronal reconstruction of upper abdominal CT shows obscure subdiaphragmatic hypodense lesion (arrows) adjacent to inferior surface of right middle lobe. C. Coronal 3D-maximum intensity projection reconstruction of conventional MR cholangiography demonstrates stenosis of common bile duct (arrows) as well as fistulous bronchobiliary communication. D. Coronal 3D-maximum intensity projection reconstruction of contrast-enhanced MR cholangiography reveals contrast agent leaking from ventrocranial branch of right hepatic duct and further into subphrenic liver cyst (arrowheads), which transdiaphragmatically communicates with bronchial tree. Stricture of common bile duct is also demonstrated (arrows).

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